Let's talk about sex and diabetes

Let’s talk about sex and diabetes

Although some sexual disorders are well understood in men with diabetes, we know little about the prevalence, impact, and management of sexual dysfunction in women with diabetes. At the ADA Scientific Sessions, Dr. Sharon Parrish provided an overview of what we know about this topic.

Dr. Sharon Parrish, Professor of Medicine and Clinical Psychology and Professor of Clinical Medicine at Weill Cornell Medicine, gave a fascinating presentation on the third day of the 82nd Scientific and ADA sessions that included a broad overview of sexual disorders and dysfunction in women with diabetes.

What sexual disorders do women with diabetes face?

There are a number of sexual disorders that can specifically affect women and women with diabetes. These include hypoactive sexual desire disorder (HSDD) (reduced sexual desire and stimulation), female sexual arousal disorder (reduced sexual arousal), and female orgasmic disorder (decreased frequency, intensity, or pleasure of orgasms, and/or delay, spontaneous, or premature orgasms), among many others.

How common is impotence?

The prevalence of these cases is frustrating. Research shows that in sexually active women with type 2 diabetes, up to:

  • 50% have desire problems

  • 34% have problems with arousal

  • 36% have lubrication problems

  • 36% have orgasm problems

More recent data shows that these rates may actually be slightly lower, and there are differences between type 1 and type 2 diabetes. Women with type 1 diabetes have a greater prevalence of ED, including decreased desire, lubrication, and arousal. In women with sexual dysfunction, there are also higher rates of diabetes stress, poor emotional well-being, and anxiety.

Reasons why these conditions appear more prominent in women with diabetes can include hormonal causes, infections, high blood sugar affecting vaginal lubrication, neurological damage, and increased rates of mental health conditions such as depression.

What are the risk factors?

Risk factors for these sexual dysfunctions include advanced age, obesity, smoking, higher A1C, and longer duration of diabetes. Interestingly, depression and marital status are important indicators of sexual dysfunction in women.

The importance of sexual dysfunction screening and reducing stigma

Parrish stressed that screening is key, but that these conversations should be initiated by health care providers by asking open-ended questions. “Have them tell you a story, and ask follow-up questions,” she said.

And as someone with diabetes, being honest with your health care provider about how diabetes affects your sex life can help. If they don’t bring up the topic, and you’re comfortable, start the conversation yourself. This can help normalize talking about sex and reduce the stigma associated with these conversations – all people deserve to have a healthy and fulfilling sex life.

Treatment options for some sexual disorders in women with diabetes

For women with HSDD, Parish breaks down three treatment options. If you have this condition, ask your healthcare provider if any are available to you.

For premenopausal women, Flibanserin can raise the hormones in your brain that lead to sexual desire and Bremelanotide (an on-demand injection) can increase desire and reduce stress. Although there is little research in this area, there is some evidence that off-label testosterone injections can moderately improve libido in postmenopausal women.

Additionally, if the root cause of HSDD has been determined to be related to a psychiatric or relationship/lifestyle problem, counseling, cognitive behavioral therapy, or psychotherapy can also be good treatment options.

Finally, Parrish outlined some of the signs and symptoms of vulvar and vaginal atrophy (VVA) and genitourinary menopausal syndrome (GSM) and treatment options. These conditions, which occur after menopause, can lead to loss of flexibility, soreness, dryness, irritability, and burning. They may be treated with lubricants and moisturizers or with a low dose of vaginal estrogen.

Why is sexual health important?

Sexual health is an important part of your overall health. Talking to your health care team about how diabetes affects your sex life, and finding ways to address the root causes of any problems you notice, can improve not only this area of ​​your life but also your emotional and mental health. It’s also important for health care providers to help start these conversations in their clinic.

For more information on women’s health:

2022-06-06 04:26:09

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